Gastric Cancer with Disseminated Bone Marrow Carcinomatosis Initially Presenting with Paraneoplastic Abducens Nerve Palsy
Parésia Paraneoplásica do Nervo Abducente como Apresentação Inicial de Cancro Gástrico com Metastização para a Medula Óssea
DOI:
https://doi.org/10.60591/crspmi.185Palavras-chave:
Acidente Vascular Cerebral, Doenças do Nervo Abducente/complicações, Neoplasias, Metástases Neoplásica, Neoplasias do EstomagoResumo
Aproximadamente 5%-10% dos acidentes vasculares cerebrais (AVC) criptogénicos têm uma neoplasia subjacente. A parésia do nervo abducente em doentes com neoplasia encontra-se geralmente relacionada com compressão tumoral, hipertensão intracraniana ou metastização.
Os autores reportam um caso de um doente com 65 anos
com AVC multiterritório que se apresentou com uma parésia do sexto nervo unilateral e isolada cuja etiologia foi extensamente estudada. Admitiu-se o diagnóstico final de síndrome paraneoplásico, que foi a apresentação inicial de um carcinoma gástrico oculto provavelmente relacionado com a hipercoagulabilidade associada à malignidade.
Este caso enfatiza a importância de considerar um estudo
adicional em casos selecionados de AVC criptogénico ou parésia do abducente.
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Referências
Kneihsl M, Enzinger C, Wünsch G, Khalil M, Culea V, Urbanic-Purkart T, et al. Poor short-term outcome in patients with ischaemic stroke and active cancer. J Neurol. 2016;263:150–6. doi:10.1007/s00415-015-7954-6
Navi BB, Reiner AS, Kamel H, Iadecola C, Okin PM, Elkind MSV, et al. Risk of Arterial Thromboembolism in Patients with Cancer. J Am Coll Cardiol. 2017;70:926–38. doi: 10.1016/j.jacc.2017.06.047
Salazar-Camelo RA, Moreno-Vargas EA, Cardona AF, Bayona-Ortiz HF. Ischemic stroke: A paradoxical manifestation of cancer. Crit Rev in Oncol Hematol. 2021; 157:103181. doi: 10.1016/j.critrevonc.2020.103181
J. Schwarzbach C, Schaefer A, Ebert A, Held V, Bolognese M, Kablau M, et al. Stroke and cancer: the importance of cancer-associated hypercoagulation as a possible stroke etiology. Stroke. 2012;43:3029–34. doi: 10.1161/STROKEAHA.112.658625
Uemura J, Kimura K, Sibazaki K, Inoue T, Iguchi Y, Yamashita S. Acute stroke patients have occult malignancy more often than expected. Eur Neurol. 2010;64:140–4. doi: 10.1159/000316764
Stefan O, Vera N, Otto B, Heinz L, Wolfgang G. Stroke in cancer patients:A risk factor analysis. J Neurooncol. 2009;94:221–6. doi: 10.1007/s11060-009-9818-3
Lindvig K, Mosbech J, Möller-Jensen O, Möller H. The pattern of cancer in a large cohort of stroke patients. Int J Epidemiol. 1990;19:498–504. doi: 10.1093/ije/19.3.498
Navi BB, Reiner AS, Kamel H, Iadecola C, Elkind MSV, Panageas KS, et al. Association between incident cancer and subsequent stroke. Ann Neurol. 2015;77:291–300. doi: 10.1002/ana.24325
Kung NH, van Stavern GP. Isolated Ocular Motor Nerve Palsies. Semin Neurol. 2015; 35:539-48. doi 10.1055/s-0035-1563568
Elder C, Hainline C, Galetta SL, Balcer LJ, Rucker JC. Isolated Abducens Nerve Palsy: Update on Evaluation and Diagnosis. Curr Neurol Neurosci Rep. 2016;16:69. doi: 10.1007/s11910-016-0671-4
Iguchi H. Recent aspects for disseminated carcinomatosis of the bone marrow associated with gastric cancer: What has been done for the past, and what will be needed in future?. World J Gastroenterol. 2015; 21:12249-60. doi: 10.3748/wjg.v21.i43.12249
Saffra N, Kaplow E, Mikolaenko I, Kim A, Rubin B, Jafar J. Isolated sixth cranial nerve palsy as the presenting symptom of a rapidly expanding ACTH positive pituitary adenoma: A case report. BMC Ophthalmol. 2011;11:4. doi:10.1186/1471-2415-11-4
Souayah N, Krivitskaya N, Huey-Jen L. Lateral rectus muscle metastasis as the initial manifestation of gastric cancer. J Neuroophthalmol. 2008;28:240–1. doi:10.1097/WNO.0b013e318177253a
Rohani N, Mortensen P, Lee AG. Fascicular sixth nerve palsy as a presenting sign of metastatic ovarian carcinoma. J Neuroophthalmol. 2021;41:e372–e374. doi:10.1097/WNO.0000000000001188
Kinori M, Bassat I ben, Huna-Baron R. Sixth nerve palsy as the presenting symptom of metastatic colon carcinoma. Int Ophthalmol. 2011;31:69–72. doi:10.1007/s10792-010-9408-6
Gon Y, Okazaki S, Terasaki Y, Sasaki T, Yoshimine T, Sakaguchi M, et al. Characteristics of cryptogenic stroke in cancer patients. Ann Clin Transl Neurol. 2016; 3:280–7. doi:10.1002/acn3.291
Navi BB, Kasner SE, Elkind MSV, Cushman M, Bang OY, Deangelis LM. Cancer and Embolic Stroke of Undetermined Source. Stroke.
;52:1121-30. doi: 10.1161/STROKEAHA.120.032002
Kaur H, Sasapu A, Ramos J, Govindarajan R. An unusual case of gastric cancer with bone marrow metastases and embolic phenomena as initial presentation. J Gastrointest Cancer. 2015;46:413–6. doi: 10.1007/ s12029-015-9714-3
Kim HS, Yi SY, Jun HJ, Lee J, Park JO, Park YS, et al. Clinical outcome of gastric cancer patients with bone marrow metastases. Oncology. 2008;73:192–7. doi: 10.1159/000127386
Ergun Y. Gastric cancer patients with bone marrow metastasis: a single-center experience and review of the literature. Eurasian J Med Oncol. 2017;1:160-3. doi:10.14744/ejmo.2017.65365
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Direitos de Autor (c) 2024 Tatiana Pacheco, Ana Pacheco, Susana Teixeira, Mafalda Ferreira, Lindora Pires
Este trabalho encontra-se publicado com a Licença Internacional Creative Commons Atribuição 4.0.
